Psychiatric Illness

Question 1

what is oral health like in people with psychiatric illness

Answer 1

higher erosion, caries and perio
poor OH, dental phobia, difficult access
poor OH contributes further to social withdrawal

Question 2

who is at risk of mental illness

Answer 2

parental drug abuse
low birth weight
parental unemployment
lower income
stressful life events
experience of abuse

Question 3

what are the dental implications of depression

Answer 3

chronic facial pain
burning mouth or sore tongue
TMJD

Question 4

what do people with schizophrenia experience

Answer 4

hallucinations and delusions

Question 5

what are the dental implications of schizophrenia

Answer 5

orthostatic hypotension due to drugs
xerostomia, oral pigmentation
facial dyskinesias
hypersalivation

Question 6

what does the depressive part of bipolar cause dentally

Answer 6

decline in OH
increased caries rate
increased periodontal disease

Question 7

what does the mania part of bipolar cause dentally

Answer 7

overzealous use of oral hygiene resulting in abrasion NCTSL

Question 8

what are the dental implications of bulimia nervosa

Answer 8

chronic sore throat
sialosis
caries/erosion
GORD
mouth ulcers
halitosis

Question 9

what do we need to consider when treating patients with eating disorders

Answer 9

risk of bone fracture
care with prescribing if low BMI
care with LA
no restorative until stable
IV and GA contraindicated
splints probably good

Question 10

what can we do as dentists to support people with eating disorders

Answer 10

offer safe space
do not lecture on diet
offer simple facts about dental problem
know how to signpost
offer support and regular appointments
treat as if medically compromised

Question 11

what questionnaire do we use to assess if a patient has an eating disorder

Answer 11

SCOFF

Question 12

what are the access issues for people with psychiatric issues who are out patients

Answer 12

poor time-keepers/attenders
chaotic lives
cost
geographical location
transport

Question 13

what are the access issues for people who are psychiatric in-patients

Answer 13

reliant on hospital staff to bring them to appointments

Question 14

once psychiatric patients have arrived at the practice what difficulties can we face

Answer 14

medical history hard to obtain
polypharmacy
mood

Question 15

what might we see on examination of a psychiatric patient

Answer 15

poor OH
poor cooperation
smoker
self-neglect
lower salivary flow rate
high caries/perio/oral cancer
disease prevalent
tardive dyskinesia
candida and denture stomatitis
trauma
xerostomia
poor denture hygiene

Question 16

what do we consider for treatment planning for psychiatric patients

Answer 16

be realistic
treatment can be slow
drug interactions
consider 1 stage endo
require constant motivation
offer high quality care

Question 17

what are the barriers to care for psychiatric patients

Answer 17

attitudes to oral health
attitudes to patient group
lack of education
cost
manpower
poor access to specialist services